There are eight members of the herpesvirus family: herpes simplex virus-1 (HSV-1) (usually cold sores and oral herpes), herpes simplex virus-2 (HSV-2) (usually genital herpes), varicella-zoster virus (VZV) (chicken pox, herpes zoster), Epstein-Barr virus (EBV) (mononucleosis and others), cytomegalovirus (CMV), human herpes virus-6 (roseola), human herpes virus-7, and human herpes virus-8 (Kaposi's sarcoma, Castleman's disease).  Most humans around the world eventually become infected with one or more than one of these.  They play a role in many diseases including several cancers.  Because these viruses establish a latent state in humans, medicines only control symptoms of disease or prevent outbreaks, and cannot cure the infections.  A vaccine is available for chickenpox and will soon be available for herpes simplex.

Acyclovir is a very inexpensive and effective treatment for oral (cream), genital herpes (pills), chickenpox, and herpes zoster (pills).  Valacyclovir (Valtrex) costs 27 times as much, but actually becomes acyclovir after it is absorbed by the body.  Most research suggests that they are equally effective.  The patient saves roughly $9 a day by taking the acyclovir!  Unfortunately, drug companies and the academic doctors working for them push Valtrex.

One recent study found the honey applied topically did much better for herpes lip and genital infections than acyclovir.  A large number of studies has found that honey accelerates various types of wound healing including burns, bed sores, psoriasis, gangrene, and cuts.  It is both an anti-biotic and a nutrient. Docosanol (Abreva) is available over-the-counter and does about as well as acyclovir cream.

VZV (6), HSV-1 (10), CMV (9), EBV (5), and mumps virus (9) play a significant role in the etiology of idiopathic peripheral facial palsy (Am J Otolaryngol. 2004 Nov-Dec;25(6):401-6. While HSV-1 and HSV-2 can cause genital herpes, which is spread by sexual intimacy, EB virus can also cause vaginal sores, but is not necessarily spread in the same manner (J Am Acad Dermatol. 2004 Nov;51(5):824-6.

Bell's Palsy Helped by Acyclovir and Prednisone: A 99-patient DB PC study of acyclovir 400 mg 5 times a day plus predisone 0.7mg/kg/day vs. placebo plus prednisone found that volitional muscle controlled returned faster and partial nerve damage was decrease with the medication treatment. The authors say this suggests Bell's Palsy is caused by herpes simplex. Ann Otol Rhinol Laryngol. 1996 May;105(5):371-8

Chicken Pox Helped by Acyclovir: In two DB studies of 177 children and adults, acyclovir 80mg/kg/day up to 3200mg/day helped speeding healing and lower viral shedding. The sooner treatment was started, the greater the benefit. Five days of treatment was just as good as seven. Pediatr Infect Dis J. 2001 Oct;20(10):919-26

Chicken Pox in Children Helped Some by Acyclovir: In a 815-child DB PC study of 20mg/kg acyclovir four times a day, the number of lesions, length of fever, severity of illness were all reduced by 20% or so. N Engl J Med. 1991 Nov 28;325(22):1539-44

Chicken Pox in Teens Helped by Acyclovir:  Chicken pox in teens is somewhat more serious than in children. In a 68-patient DB PC study of children 13-18 years of age found acyclovir 800 mg four times a daystarted within 24 hours of rash for five days was definitely better than placebo. J Pediatr. 1992 Apr;120(4 Pt 1):627-33

Children with Gingivostomatitis Herpes Helped by Acyclovir: A DB PC study of 82 children found acyclovir 15 mg/kg five times a day started within 3 days considerably reduced duration of symptoms (4 vs. 10 days), fever (1 vs. 3 days), lesions around mouth (0 vs. 5.5days), shedding (1 vs. 5 days), difficulty eating and drinking (3 vs. 6 days). BMJ. 1997 Jun 21;314(7097):1800-3

Erythema Multiforme Helped by Acyclovir: 20 patients with four or more episodes of erythema multiforme in a DB PC study found those on acyclovir for the six months did better. 15 of the patients had histories of their erythema multiforme being precipitated by herpes simplex recurrences. Br J Dermatol. 1995 Feb;132(2):267-70

Eye Infection: Recurrence of Herpes Simplex Prevented by Acyclovir: 68 patients in a Dutch DB PC 2 year study found that acyclovir 400 mg b.i.d. cut recurrences by 67% in patients treated with penetrating keratoplasty following corneal scarring. Ophthalmology. 2003 Oct;110(10):1916-9; discussion 1919

Eye Infection: Acyclovir Reduces Recurrences: In a DB PC 1 year study of 1070 patients with a history of herpes eye infection, recurrences were reduced by 40% with acyclovir 400 mg b.i.d. Arch Ophthalmol. 2000 Aug;118(8):1030-6

Genital Herpes Prophylaxis: Valacyclovir Cuts Transmission: Only 10% of infected even know it. A study of 1500 couples with one infected partner taking valacyclovir ( Valtrex) 500 mg daily ($135/month www.Walgreens.com 1/1/04) for 8 months cut transmission from 4% to 2% in monogamous relationships (41 cases vs. 21 cases)($50,000 medication per infection prevented or delayed). Patients were seen every month and condom usage was encouraged with each visit with condoms provided for free. Valtrex is modified acyclovir. Corey, U Wash, 10/02.  This study was finally published in New England J Medicine 1/1/04. 

    Ed: This study doesn't break much new ground. It was already very well established that treatment reduces shedding and recurrences. The biggest news is how little spread of herpes there was. Why the New England Journal chose not to require a cost-benefit analysis is beyond me (We had to do one in a study I was involved in with tobacco sales to minors enforcement).  At the very high price of valacyclovir, it amounts to $54,000 medication cost per infection prevented (or just delayed)! That's an incredible amount of money to prevent or delay the spread of a very common disease.  Research suggests that to prevent transmission treatment has to be continued for many years. Numerous studies show that the generic acyclovir works just as well.  For one year of treatment with valacyclovir, the medication cost is $1700. For acyclovir 400 mg. b.i.d., the cost is $116 per year, a savings of $1,584!  There has been a concerted campaign by drug manufacturers and their academic researchers to bad mouth acyclovir and praise valacyclovir ever since acyclovir went generic.  In fact, valacyclovir becomes acyclovir almost as soon as it is absorbed into the body. Either medicine has a very low level of side-effects. While valacyclovir is better absorbed and somewhat longer acting, the absorption does make any difference for most indications and the slight benefit in reduced frequency has had no measurable impact on compliance and comes at a very high price. For more, see Herpes.

Genital Herpes Prophylaxis: Acyclovir = Valacyclovir: In a DB study of 151 patients undergoing stem cell transplant or with low white blood cells due to chemotherapy and treated with acyclovir 400mg t.i.d. or valacyclovir 500mg b.i.d. or valacyclovir 250mg b.i.d., there was no difference between the three treatments in suppressing herpes recurrences (96% vs. 95% vs. 100%). Valacyclovir versus acyclovir for HSV prophylaxis in neutropenic patients. Warkentin DI, Epstein JB, Campbell LM, Yip JG, Cox VC, Ransier A, Barnett MJ, Marra F. Ann Pharmacother. 2002 Oct;36(10):1525-31

Genital Herpes Prophylaxis: Acyclovir = Valacyclovir: A DB 52-week study of 1479 patients who had six or more recurrences per year found no difference between valacyclovir q.d. vs. valacyclovir b.i.d. vs. acyclovir. Sex Transm Infect. 1999 Dec;75(6):398-402; A report on apparently the same study notes that the dosages were acyclovir 400 mg b.i.d. vs. valacyclovir 1000 mg q.d. vs. valacyclovir 250 mg b.i.d. J Infect Dis. 1998 Sep;178(3):603-10; Ed: The author stresses that valacyclovir is "highly effective and well tolerated" but fails to draw attention to the fact that acyclovir is just as highly effective and just as well tolerated at a cost of $116 per year vs. $3408 per year for valacyclovir! (Costs from Darby Drug 2003-4 comparing 1000 mg q.d. valacyclovir to the b.i.d. acyclovir). Research

Genital Herpes Prophylaxis: Five Years of Treatment Reported: 1100 patients were recurrent herpes were treated in a DB PC study for 1 year of acyclovir 400 mg b.i.d. then all were treated in an open study for an additional four years. The average number of episodes per year decreased with acyclovir treatment from 12.7 per year to 1.7 the first year and 0.8 the fifth year. J Int Med Res. 1994;22 Suppl 1:24A-31A; discussion 31A-32A

Genital Herpes Treatment: Valacyclovir No Better Than Acyclovir: During the first-episode of herpes genitalis, valaciclovir, at the dose of 500 or 1,000 mg twice daily, is as effective as 200 mg of aciclovir five times per day. In recurrent herpes genitalis, 500 mg twice daily of valaciclovir is as effective as 1,000 mg twice daily or 200 mg five times a day of aciclovir. Valaciclovir prevents recurrence herpes genitalis with a dose-dependent effect, and doses of 500 and 1,000 mg/day are as effective as 400 mg twice daily of aciclovir. Ann Dermatol Venereol. 2002 May;129(5 Pt 1):708-15

Genital Herpes Treatment: Valacyclovir No Better than Acyclovir: A French DB 7-day study of 142 patients given valacyclovir 500 mg. b.i.d. vs. acyclovir 200 mg. five times a day found no significant difference. There was actually a slight trend favoring the acyclovir. Enferm Infecc Microbiol Clin. 2001 Jan;19(1):15-8

Genital Herpes Treatment: Valacyclovir No Better than Acyclovir: A very large 1200-patient 5-day DB study found valacyclovir 1000 mg bid and acyclovir 200 mg five times a day both did just as well and better than placebo. Univ Texas, Galvaston. Industry-funded. Arch Dermatol. 1998 Feb;134(2):185-91. Ed: As usual, the authors praise valacyclovir for being more convenient with no mention of the huge cost difference.; The same with an Indiana University, industry-funded study of 643 patients. Sex Transm Dis. 1997 Sep;24(8):481-6; The same with a Sydney, Australian, industry-funded study of 739 patients. Genitourin Med. 1997 Apr;73(2):110-6

Genital Herpes Treatment: Famiciclovir No Better than Acyclovir: 204 patients in 5-day DB study found famiciclovir 125 mg b.i.d. did no better than acyclovir 200 mg. five times a day. Br J Dermatol. 2001 Apr;144(4):818-24. Famiciclovir is much more expensive, something the authors fail to mention.

Genital Herpes Treatment: High Dose Acyclovir No Better than Standard: First time herpes patients (139) in a DB study were given 200 mg or 800 mg five times a day. Antimicrob Agents Chemother. 1994 Feb;38(2):174-6

Genital Herpes Treatment: 3-Day Treatment as Effective as 5-Day: A DB study of 800 genital herpes patients found that valacyclovir 500 mg b.i.d. for three days was just as effective as the same for 5 days. Clin Infect Dis. 2002 Apr 1;34(7):958-62. 

Genital Herpes Treatment: 2-Day Treatment with Acyclovir Better than Placebo: A DB PC study of 131 patients with recurrent herpes found the duration of symptoms decreased from 6 days to 4 days with acyclovir 800 mg t.i.d.  Clin Infect Dis. 2002 Apr 1;34(7):944-8. Ed: This degree of improvement is as good as in other studies.  Also, note that the medicine is being given only three times a day. Two to three days of treatment is now preferred. Ann Pharmacother. 2003 Dec;37(12):1900-3

Genital Herpes: Treatment Reduces Spread: In a study of Peter Leone of the University of North Carolina, viral shedding was reduced by 75% while on famciclovir vs. placebo. 10/21/06.

Herpes Zoster Vaccine Markedly Reduced Suffering from Herpes Zoster: Up to 60% of adults over age 60 will at some point have a recurrence of the chicken pox/herpes zoster virus in the form of a painful skin rash. In a DB PC study of 38,546 adults over age 59, those given the live attenuated Oka/Merck VZV vaccine had half as many cases of herpes zoster (315 among vaccine recipients vs. 642 with placebo) and 107 cases of postherpetic neuralgia (27 vaccine vs. 80 placebo). The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5% (P<0.001), and reduced the severity in vaccinated who developed zoster rashes. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Oxman MN, Levin MJ, et al. University of California, San Diego. N Engl J Med. 2005 Jun 2;352(22):2271-84.

Herpes Zoster: Nortriptyline as Good as Narcotics for Postherpetic Neuralgia: In a DB PC crossove study of 76 patients with postherpetic neuralgia, morphine 91 mg or methadone 15 mg did not better than nortriptyline 89 mg or desipramine 63 mg. Opioids and tricyclics (TCA) reduced pain (1.9 and 1.4) more than placebo (0.2; p < 0.001). The trend favoring opioids over TCA fell short of significance (p = 0.06), and reduction in pain with opioids did not correlate with that following TCA. Treatment with opioids and TCA resulted in greater pain relief (38 and 32%) compared with placebo (11%; p < 0.001). More patients completing all three treatments preferred opioids (54%) than TCA (30%; p = 0.02). Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebo-controlled trial. Raja SN, et al. Johns Hopkins. . Neurology. 2002 Oct 8;59(7):1015-21. Ed: Nortriptyline is much preferred over desipramine both because nortriptyline is much better researched for pain relief and has a much higher safety index in overdose. Nortriptyline plus a non-narcotic pain relievers would undoubtedly have been far superior to a narcotic by itself and very likely just as good as the narcotic with a non-narcotic pain reliever.  It borders on medical malpractice to give opiates for PHN, since PHN is a temporary condition, the narcotics are obviously unnecessary, and the narcotics too often lead to serious addiction problems. 

Herpes Zoster Treatment: In Germany acyclovir, valacyclovir, famciclovir and brivudin are approved for the systemic antiviral treatment of herpes zoster.  Acyclovir, valacyclovir, and famciclovir have similar efficacies. Am J Clin Dermatol. 2002;3(9):591-8. Amitriptyline helps with the pain.

Herpes Zoster: Valacyclovir = Famciclovir: In a huge but humorous DB 7-day study of 597 herpes zoster patients given one of two patented medications, valacyclovir 1000 mg t.i.d. or famciclovir 500 mg t.i.d. there was no difference in effectiveness. The study followed patients for 24 weeks. The authors make a big deal over valacyclovir being more cost-effective because it costed only $84 instead of $141 for famciclovir. Arch Fam Med. 2000 Sep-Oct;9(9):863-9. Of course, acyclovir would have cost about $5!

Herpes Zoster: Acyclovir Very Good in One Study. Valacyclovir Better in a Second: An odd report on two studies of 1079 zoster patients reports that in the first study, patients treated with acyclovir improved much more quickly than patients treated with placebo (28 days vs. 62 days). However, in the second study, when acyclovir was compared to valacyclovir, the valacyclovir totally relieved the pain in 40 days vs. 50 days for the acyclovir. J Infect Dis. 1998 Nov;178 Suppl 1:S81-4

Herpes Zoster: High Dose Valacyclovir Somewhat Better than Acyclovir: In a large DB study of 1,149 patients, valacyclovir 1,000 mg t.i.d. for 7 or 14 days did better than acyclovir 800 mg q.i.d. at relieving pain totally in 38 and 44 days vs. 51 days although pain intensity and quality of life were no different. Antimicrob Agents Chemother. 1995 Jul;39(7):1546-53

Herpes Zoster: Famciclovir = Acyclovir in Immunocompromised: In a 148-patient DB study of transplant or chemotherapy patients with localized herpes zoster, famiciclovir 500 mg t.i.d. did the same as acyclovir 800 mg five times a day for 10 days.  Authors stress the convenience of famciclovir but fail to mention its price in much, much higher. Cancer Invest. 2001;19(1):13-22

Herpes Zoster Opthalmicus: Acyclovir = Valacyclovir: In a DB study of 110 patients with herpes zoster infection of the eye, valacyclovir 1000 mg t.i.d. was no better than acyclovir 800 mg five times a day.  Ophthalmology. 2000 Aug;107(8):1507-11. Ed: The author stresses the convenience of valacyclovir but fails to mention the difference in cost: $12 for the acyclovir and $199 for valacyclovir (Darby Drugs 2003-4). This is like getting paid $13 each extra time you had to take a single acyclovir pill. Even a physician would like getting paid that kind of money1 

Herpes Zoster: Acyclovir Plus Predisone Best: In a 4-celled DB PC study of Acyclovir 800 mg fives times a day for 21 days plus predisone 60 mg/day at first then gradually decreased, the combination did best. Ann Intern Med. 1996 Sep 1;125(5):376-83 

Herpes Zoster: Ganoderma Concoction Appears to Help: Administration of hot water extracts of a herbal formula containing Ganoderma lucidum, WTMCGEPP (Wisteria floribunda 0.38, Trapa natans 0.38, Miristica agrans 0.38, Coix lachryma-jobi 0.75, cultivated Ganoderma lucidum 0.75, Elfuinga applanata 0.38, tissue cultured Panax ginseng 0.3, and Punica granatum 0.38: numerals designate dry weight gram/dose), decreased herpes zoster pain for five Japanese patients suffering from shingles. Pain relief started within a few days of intake and was almost complete within 10 days. Two acute herpes zoster with manifestations including trigeminal nerve ophthalmia (both 74 years old), lower body zoster (70 years old), herpes zoster oticus (17 years old), and leg herpes (28 years old), responded quickly to treatment and no patient developed post-herpetic neuralgia (PHN) after more than one year of follow-up. Effect of an herbal formula containing Ganoderma lucidum on reduction of herpes zoster pain: a pilot clinical trial. Hijikata Y, et al. Osaka, Japan. . Am J Chin Med 2005;33(4):517-23.

HIV Patients: Valacyclovir = Acyclovir for 1 Year Suppression of and for Brief Treatment of Herpes Simplex: Two DB studies of HIV patients receiving HAART therapy found that in 1083 patients given valacyclovir 1000 mg. once a day there tended to be slightly more recurrences than with acyclovir and that with valacyclovir 500 mg b.i.d. there tended to be slightly fewer recurrences.  In 5-day treatment of recurrences in another 462 HIV patients, there was no difference in effectiveness between valacyclovir 1000 mg b.i.d. and acyclovir. Int J STD AIDS. 2002 Jan;13(1):12-21

HIV Mortality Decreased by Acyclovir: One study reveals a 26% decrease in the risk of death in persons taking both acyclovir and AZT. If acyclovir treatment was initiated after a clinical diagnosis of AIDS, the risk of death was reduced by 44%. These risk reductions are roughly equivalent to an increased survival time of six months to one year. Common Factor. 1995 Apr;(no 10):14

Lip: Acyclovir Didn't Prevent Recurrence of Sun-Induced Herpes: A DB PC study of 239 Canadian skiers with histories of recurrent herpes induced by prolonged sun exposure (>3hr) found that acyclovir 800 mg b.i.d. for 3-7 days starting 12-24 hours before exposure didn't prevent recurrence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Jan;85(1):55-9.

Lip: Acyclovir Ointment Did Reduce Sun-Induced Herpes: In a DB PC U.S.-Canadian study of 181 skiers, acyclovir ointment prophyllactically did reduce the number of lesions from 40% to 21%. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Dec;84(6):641-5

Lip: Iontophoretic Applicator Increases Acyclovir Effectiveness: Using an experimental low-voltage, wireless, hand-held, computer-controlled, iontophoretic applicator to enhance the skin penetration of topical acyclovir in the treatment of herpes labialis, a single, topical, iontophoretic application of 5% acyclovir cream for the episodic treatment of herpes labialis among 200 patients reduced classic lesion healing time by 1.5 days for the active treatment group vs. vehicle alone (113 h vs. 148 h; P = .02). In the subgroup of patients with lesions in the erythema stage, the median classic lesion healing time was 3 days shorter for the acyclovir group, compared with the control group (49 h vs. 120 h; P < .03), and the acyclovir group tended to have more aborted lesions than did the control group (46% vs. 24%; P = .10). Topical iontophoretic administration of acyclovir for the episodic treatment of herpes labialis: a randomized, double-blind, placebo-controlled, clinic-initiated trial. Morrel EM, et al.  Transport Pharmaceuticals, Framingham, Massachusetts. Clin Inf Dis 2006 Aug 15;43(4):460-7.

Lip: Allopurinol May Help: Xanthine oxidase inhibitors have a potent antiviral effect against influenza-A virus. In a controlled study of patients with recurrent herpes labialis over 4 years, those taking allopurinol starting at the beginning of a cold or at the first sign of a recurrence had the duration of illness shortened by about 25%, and early disappearance of pain. Patients receiving 3 courses of treatment had markedly decreased recurrences during the follow up period.  Allopurinol as a potential therapeutic agent for recurrent herpes labialis. El-Farrash MA, Youssef JM, El-Mongy SE. Mansoura University, Egypt. J Med Dent Sci. 2003 Jun;50(2):147-54.

Lip: Anti-Virals All Shorten About a Day: There are no studies comparing different anti-virals. Of five DB PC studies available, all shorten the duration by about a day. Ann Pharmacother. 2004 Apr;38(4):705-9. 

Lip: Docosanol Over-the-Counter Antiviral Helps: Docosanol (Abreva) 10% cream OTC ($17) five times per day at first sign of recurrence and before papule stage shortens duration of sore in DB studies. It works by inhibiting viral fusion. Appears to be about as good as two prescription treatments available: Zovirax ($25) and Denavir ($27). Med Letter 11/13/00.

Lip: Honey Did Better than Topical Acylovir for Lip and Genital Herpes: In a study with 16 adults with a history of recurrent attacks of herpetic lesions, 8 labial and 8 genital, all were treated by topical application of honey for one attack and acyclovir cream for another attack. For labial herpes, the mean duration of attacks and pain, occurrence of crusting, and mean healing time with honey treatment were 35%, 39%, 28% and 43% better than with acyclovir treatment. For genital herpes, the mean duration of attacks and pain, occurrence of crusting, and mean healing time with honey treatment were 53%, 50%, 49% and 59% better than with acyclovir. Two cases of labial herpes and one case of genital herpes remitted completely with honey. The lesions crusted in 3 patients with labial herpes and in 4 patients with genital herpes. With acyclovir treatment, none of the attacks remitted, and all the lesions, labial and genital, developed crust. No side effects were observed with repeated applications of honey, whereas 3 patients developed local itching with acyclovir. Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions. Al-Waili NS. Dubai, United Arab Emirates. Med Sci Monit. 2004 Aug;10(8):MT94-8.

Lip: Light Treatment Much Faster than Acyclovir: In a small DB PC study, patients treated with 5 minutes of 1072 nm light healed much faster (4 days) than with topical acyclovir 5 times a day (8 days). A pilot study of treatment of herpes labialis with 1072 nm narrow waveband light. Dougal G, Kelly P. Clin Exp Dermatol. 2001 Mar;26(2):149-54

Lip: Liposomal Cream with Acyclovir Better than Standard Acyclovir cream: Jerusalem. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Jun;87(6):700-5

Lip: Sage-Rhubarb Ointment = Acyclovir Ointment: In a DB study of 145 patients, the study compared sage ointment, sage-rhubarb, and zovirax. Sage and rhubarb had both done well on screening search. Time to cure 7.6 days with sage, 6.5 with combo, 6.3 with Zovirax. Forsch Komplementarmed Klass Naturheilkd. 2001 Dec;8(6):373-82.

Lip: Tea Tree Oil Gel Helped a Little: In a randomized study of 18 patients with recurrent herpes labialis applying gels 5 times a day, 3 using a 6% TTO gel and one using an inactive bodycare gel were never HSV culture-positive but their median times to presentation were 2 and 1 days, respectively, and later presentation may have contributed to the failure to detect HSV by PCR or culture. The median time to skin recovery  with TTO was 9 days vs. 12.5 with placebo. TTO treatment caused a modest reduction in the median duration of culture positivity (3 compared to 4 days). There was no difference in median time to crust formation: 4 days. Viral titres appeared lower in the TTO group than in the placebo group at days 3 (5.1 x 10⁴ to 5.8 x 10⁶ pfu/mL, respectively) and 4 (10 to 2.1 x 10³ pfu/mL, respectively) after onset, but these differences did not reach statistical significance. The reduction in time to re-epithelialization seen in the TTO group was similar to reductions reported previously for other topical therapies. Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. Carson CF, Ashton L, et al. J Antimicrob Chemother. 2001 Sep;48(3):450-1.

Lip: Zinc-Oxide and Glycine Cream Helped a Little: In a DB PC study of 46 adults with facial or circumoral herpes infections, a zinc oxide/glycine cream cream every 2 hours started within 24 hours of onset of symptoms shortened the duration of cold sore lesions (5.0 vs. 6.5 days) with a reduction in blistering, soreness, itching, and tingling. Side effects of zinc oxide/glycine cream were completely reversible and of short duration.  A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. Allterra, Inc, Huntingdon Valley, Pa., USA. Altern Ther Health Med. 2001 May-Jun;7(3):49-56.

Multiple Sclerosis May Be Helped by Acyclovir: A 60-patient DB PC study of acyclovir 800 mg t.i.d. for two years found 34% fewer exacerbations with acyclovir (p=.08) with patients with illnesses of greater than two years in duration being significantly benefited and significant difference by grouping patients by frequency. J Neurol. 1996 Mar;243(3):214-24

Pregnancy: Women with Recurrent Herpes Helped by Acyclovir: In a DB PC study of 162 pregnant women who had histories of recurrent herpes infections and who were treated with placebo or acyclovir 400 mg t.i.d. from 36 weeks of gestation until delivery found that herpes culture and PCR detection at time of delivery was markedly reduced by acyclovir (0% and 2% vs. 7% and 34%). The number of C-sections was markedly reduced (4% vs. 10%). Am J Obstet Gynecol. 2003 Mar;188(3):836-43; Similar findings in Infect Dis Obstet Gynecol. 2002;10(2):71-7; Similar results with 46 women developing herpes for the first time during pregnancy with 0% vs. 36% of those on placebo receiving C-sections for active herpes at time of delivery. Obstet Gynecol. 1996 Jan;87(1):69-73

Vaginal Shedding Very Frequent; Helped by Acyclovir: Daily swabs of vaginal secretions in 27 women with histories of genital herpes found PCR evidence for herpes simplex on 28% of all days and viral isolation was measured on 8% of days. When women were put on acyclovir 400 mg b.i.d., PCR evidence was reduced by over 80%. Within 3-4 days of stopping acyclovir, shedding returned to original levels. J Clin Invest. 1997 Mar 1;99(5):1092-7; This shedding is much more frequent than previously expected and probably explains the high rate of herpes in the population. One study of providing condoms to monogamous couples with one infected partner found that condoms protected women from getting infected men but not vice versa. This rapid return of shedding probably means that to prevent infection, the acyclovir probably needs to be taken year after year indefinitely.

Finland: Herpes and Other Viruses Common: Seroprevalences among 550 women at delivery were 96.2% for VZV (chicken pox), 56.3% for CMV, 54.3% for HSV, 46.8% for HSV-1, 9.3% for HSV-2 and 58.6% for parvovirus B19. BJOG. 2005 Jan;112(1):50-6.

Germany: Herpes Very Common: In a representative national sample testing 3,792 Germans, 82.6% tested positive for HSV-1 and 16.5% for HSV-2. Eur J Clin Microbiol Infect Dis. 2005 Feb;24(2):131-5.

U. S. Teens Most with Herpes: Seroprevalence data on adolescents from the United States and found HSV-1 rates of 53.1 percent for adolescent males and 49.4 percent for adolescent females. The weighted means for HSV-2 was 15 percent for adolescent females and 12 percent for adolescent males. Most individuals who are infected with HSV-2 are unaware of their infection. Semin Pediatr Infect Dis. 2005 Jan;16(1):24-30; The incidence of trichomoniasis (Trichomonas vaginalis) in the United States is estimated at 5 million cases annually; chlamydia (Chlamydia trachomatis) at 3 million; gonorrhea (Neisseria gonorrhea), 650,000; and syphilis (Treponema pallidum), 70,000. However, most sexually transmitted infections (STIs) are asymptomatic-contributing to underdiagnosis estimated at 50% or more. J Am Osteopath Assoc. 2004 Dec;104(12):527-35.

U.S.: Two-Thirds of Adults HSV-1 Positive: In the nationally representative NHANES II study from 1976-80, 70% of American over age 11 were positive for HSV-1 antibodies.  In the NHANES III study from 1988-94, the HSV-1 rate was 68%. Prevalence increased with age and varied by race/ethnicity; the majority of persons in all race/ethnic groups were HSV-1-seropositive by age 30. Sex Transm Dis. 2004 Dec;31(12):753-60.

Fatigue, Colds, Sun Cause Flare-Ups: Among 3678 Japanese with HSV-1, 2656 (72.2%) had a recurrent flare-up. Fatigue was the most commonly reported cause of a flare-up among all patients, followed by the common cold and sun exposure. Sun-induced HSV-1 flare-up was reported by 10.4% of the total study population. However, this increased to 19.7% among patients diagnosed in July and August, to 28% among patients younger than 30 years diagnosed in July and August.

In 18 cases of new daily persistent headache (NDPH), a rare chronic headache, tests showed a recent herpes simplex virus infection in 42%, cytomegalovirus in 11%, and EBV infection in 0%. Earlier reports suggested a possible link with EBV. New daily persistent headache: clinical and serological characteristics in a retrospective study. Meineri P, Torre E, et al. Cuneo, Italy. Neurol Sci. 2004 Oct;25 Suppl 3:S281-2.